The sharing of needles among injection drug users (IDUs) is a common route of Human Immunodeficiency Virus and Hepatitis C Virus transmission. Through the increased utilization of social network analysis, researchers have been able to examine how the interpersonal relationships of IDUs affect injection risk behaviour. This study involves a secondary analysis of data from a cross-sectional study of 156 IDUs from Winnipeg, Manitoba titled “Social Network Analysis of Injection Drug Users”. Multiple logistic regression analysis was used to assess the individual and the social network characteristics associated with needle sharing among the IDUs. Generalized Estimating Equations analysis was used to determine the injecting dyad characteristics which influence needle sharing behaviour between the IDUs and their injection drug using network members. The results revealed five key thematic findings that were significantly associated with needle sharing: (1) types of drug use, (2) socio-demographic status, (3) injecting in semi-public locations, (4) intimacy, and (5) social influence. The findings from this study suggest that comprehensive prevention approaches that target individuals and their network relationships may be necessary for sustainable reductions in needle sharing among IDUs.